XELOX combined with bevacizumab in older metastatic colorectal cancer patients

This study investigated the safety and efficacy of chemotherapy (capecitabine and oxaliplatin, or XELOX) combined with bevacizumab (Avastin) as treatment for metastatic (spread to other areas of the body) colorectal cancer in patients 75 or more years old.

Researchers suggested that XELOX plus bevacizumab was effective in patients aged 75 or older with metastatic colorectal cancer, with manageable side effects.  

Colorectal cancer is one of the most common cancers in woman and men worldwide. Xelox plus bevacizumab has been shown to be an effective treatment in patients with metastatic colorectal cancer. However, many clinical trials iinclude only younger patients. Less is known about the effectiveness of this treatment combination in elderly patients. Recently, a study conducted in Spain showed that XELOX plus bevacizumab was effective and well tolerated by elderly patients (70 years or older) with metastatic colorectal cancer. However, the safety and efficacy of XELOX plus bevacizumab still needs to be investigated in patients 75 years or older, as well as patients of other ethnicities. 

This study investigated the safety and efficacy of bevacizumab in combination with XELOX for treatment of metastatic colorectal cancer in Japanese patients aged 75 or more years. This study included 36 patients with metastatic colorectal cancer aged 75 or more years that had not undergone previous chemotherapy. Patients were treated with bevacizumab in combination with XELOX chemotherapy.

Progression free survival (PFS; time to disease progression), overall survival (OS; time from beginning the trial to death from any cause) and time to treatment failure (TTF; time from beginning the trial to finishing the treatment for any reason).

The average PFS was 11.7 months and OS was 22.9 months. The average TTF was 7 months.

Common non-severe negative effects of the treatment included numbness or pain due to nerve damage (83.3%) and low levels of red blood cells (80.5%). Other side effects included low levels of blood platelets (58.3%), hand-foot syndrome (swelling and pain of hands and/or feet; 58.3%), and low levels of white blood cells (55.6%). Common severe negative effects included low levels of white blood cells (22%) and nerve damage (13.9%). There was one death related to the treatment.

This study concluded that a combination of chemotherapy XELOX and bevacizumab was effective as a first-line treatment for metastatic colorectal cancer in patients with 75 or more years old. The negative effects of the treatment were manageable.

This study included only Japanese patients. 

Discuss with your doctor whether a XELOX/bevacizumab treatment combination would be effective for your situation.